Individual provider Active NPI

Patricia Ann Geniesse

  • Pediatric Physical Therapist
  • Naperville, IL
National Provider Identifier
1376739540
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Practice address
1804 Centre Point Cir
Suite 102
Naperville, IL 60563-1440
Phone
(630) 955-1940
NPI assigned
Sep 20, 2007
Last updated
Sep 20, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X IL Primary

Addresses

Primary practice location

1804 Centre Point Cir
Suite 102
Naperville, IL 60563-1440

Mailing address

671 Westridge CT
Aurora, IL 60504-3229
Phone (630) 204-8827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070004496ILMDPediatric Physical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1376739540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 WESTRIDGE CT",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605043229",
            "telephone_number": "630-204-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 CENTRE POINT CIR",
            "address_2": "SUITE 102",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631440",
            "telephone_number": "630-955-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENIESSE",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.